Why do doctors wait until chronic medical conditions such as high blood pressure or blood sugar become acute enough to cause damage before they will begin treatment? Why not start treatment with lower dose medications before damage begins?

Answered Jan 7, 2019

There are two angles here. Which relate to things other than blood pressure and blood glucose.

First, some patients are actually over-paranoid about minor symptoms or indications on tests. And some of them use “Dr. Google” to encourage that paranoia.

Also, some patients are negligent, and have behaviours which cause/encourage their medical damage.

Second, there are doctors (with actual legit medical degrees) who are cavalier, and even incompetent, to the point of compromising patient safety/health/lifespan.

I have personally witnessed a situation where a very informed/knowledgeable patient faced a dismissive and ignorant doctor.

The patient tried to explain major issues in her medical history, and the doctor didn’t seem to comprehend. And also failed to write down basic things like medication use, while denying the patient’s concerns about side-effects. Which are actually mentioned in the information sheet included with the prescription pills. And which the patient had studied by reading legitimate scientific journal articles (because she is actually a scientist).

That doctor failed to comprehend the timeframe of the symptoms, and ordered tests, which the patient (who has a degree in a relevant field) knew were irrelevant.

A different, actually-relevant set of blood tests came back with alarming numbers (with the patient’s eyes bugging out as she read it). And that doctor dismissed it as, “Some people are out of range, everything is just fine for them”. Without mentioning that, only 2.5 percent of the population is in that group. And getting a creepy tone when the patient said that she would compare the recent readings with some previous ones.

And, speaking of creepy, that doctor got a creepy tone when the patient requested further tests for a viral disease which may have been sexually transmitted (although she was later cleared on that).

That patient was also bullied by a nurse at the same clinic, trying to convince her that she is in menopause, when she knows otherwise.

The patient was told that, her physical symptoms aren’t real.

She wasn’t trying to scam sympathy or pain meds. She was trying to stop vomiting.

That patient is now awaiting evaluation for a potentially life-threatening (and actually rather common) condition. And won’t be seeing that doctor again, unless necessary to pick up results from a referral (N.B. this is the New Zealand public heath system). Delayed diagnosis and treatment increases the danger of an emergency arising.

There is an enormous culture of condescension towards patients, by medical professionals. They assume that you couldn’t possibly know anything about how the human body is put together, or how it works. They assume that you don’t know your own medical history, or your risk factors, or your symptoms.

Some of them simply don’t listen when you try to give them important information.

Also regarding the NZ public heath system, we have waiting lists here. This became a political issue 10 or 15 years ago, with excessive time frames. The government solved that by kicking people off of waiting lists for examinations and procedures. Just to make the lists look shorter and more efficient.

They have actually told people that they aren’t sick enough, and to reapply when their problem becomes worse. Which for some, will inevitably happen, increasing the chance of complications, emergencies, and fatalities.